High Lipoprotein (a)

My first reaction is that you are over thinking it. You sound very healthy and are doing all the right things. I had high cholesterol and a high Lipo # but I didn't take medication because I thought I could take care if it with diet & exercise. Didn't work out. I got a minor heart attack and 4 stents in my heart. So all in all I think that you are in a good place...good luck !

I also have high Lp(a) also. My mother had a quadruple bypass. I had normal cholesterol for many years and good HDL. Ran regularly 20-30 miles a week for decades. During X-rays for something else, they found calcifications in the iliac arteries. So they did a CAC and I was in the 98th percentile for coronary atherosclerosis. The biggest thing a doctor would do for you is likely prescribe statins, which you are already on. But there are lifestyle changes you can make also to keep it from progressing (IF you have atherosclerosis, which you may not). So my 2 cents would be to find a preventive cardiologist and discuss it with him/her. I had the Lp(a) test at Mayo, and they gave me a letter to give to my immediate family letting them know it’s a genetic risk factor. This also, I think, is a reason to discuss it with a preventive cardiologist. No reason to panic, but not something to ignore would be my take. Good luck! BTW, I don’t think statins increase Lp(a) and you can’t lower it much. We just got bad genes.

Thank you @bitsygirl

My understanding is 1 in 5 people have elevated LP(a). I do not have it but my 89-year old father does (and he’s alive and kicking). It sounds like you have found a knowledgeable doctor you trust. You can find reliable information to help you discuss more with them at https://familyheart.org/. They exist because of genetic conditions familial hypercholesterolemia and LP(a).

I had a heart attack April 25, 2023. My numbers were all within normal ranges and my new cardiologist after everything was done said no one would consider putting me on meds.

I was at the gym doing a crossfit workout and had chest pain that I though was muscle strain. I stopped and went home. After two days of just feeling off, I went to a walk-in clinic, they sent me to the ER. All of my tests looked normal, but my blood work came back with elevated enzyme showing heart distress, they had drawn multiple times and it was on the decline. They admitted me and scheduled a CAC, I had 100% blocked LAD with home grown bypasses. They installed two stents.

I was later tested for lipid(a) and found to have a score around 170.

My cardiologist says there is nothing to do about that number and to focus on lowering my LDL to below 50, and salts and Saturated fats from my diet.

I don't get as many steps in as you do, probably only 25k - 32k. I'm active but haven always been. I would find a Cardiologist that is aware of the current studies being done about L(a) and get in to see them. But also keep working at being heathly and not over thinking.

My husband just got the results back from his lab last week, LPA 278, we are concerned.
Last result in November was 209.
( I didn’t had it print out and checked out every single blood number, as the the doctor flew over it with and didn’t say anything about the high number of LDA.
He had a stent put in a year ago (his main artery was blocked 90%) and is on statins, mini aspirin since then…
All other blood result are fine.
We were reading, there is not much you can do about it, than trying to live a healthy lifestyle as good as you can. I was ready too, that it could be a side effect from statins?
We are overwhelmed and would be thankful for every idea.

Sorry to hear about what you’ve been experiencing. There are some studies now saying getting LDL below 70 for most, below 50 for people who are high risk, can reverse cardiovascular disease. My LDL started at 109 with the highest statin one could take and also with Zetia. It’s now at 27 after adding Repatha.

I just read over the weekend the results of a phase 2 drug trial that lowered Lp(a) by 90%, so you might want to be watching what happens there, although it’s likely 5+ years before we’ll see these new drugs on the market.

Clinicaltrials.gov is a website to look for drug trials if you’re interested

Good luck in this journey!

I’ve been taking Lipitor, 80mg, from the day it came out (I was part of the stage 3 clinical trial), and it lowered my total cholesterol from the 400’s to under 200 and LDL from the mid 200’s to around 100. Virtually no meat or fried foods, very little saturated fat in my diet my whole adult life.
Now I learn my CAC score has me in the 75% percentile, meaning worse than 3/4 of the people my age. Lovely. And a bad family history from both my parents.

I’m now on a plant based diet, more meds, and my cardiologist has me taking, in addition to a multivitamin, a plant based Omega 3 supplement. He’s really focused on my Lipoprotein B levels, as that seems to be the carrier for cholesterol that’s gets deposited in blood vessels.

Good luck in your journey

There are new drugs in phase 3 trials to lower it. Probably a couple years away.

Good luck. Please keep us posted.